Objective To investigate the impacts of ultrasound-guided stellate ganglion block(SGB)on hemodynamics and postoperative cognitive function in patients undergoing shoulder arthroscopic surgery.Methods From January 2024 to June 2024,120 patients undergoing shoulder arthroscopic surgery in our hospital were randomly assigned into general anesthesia group(n=60,implementing general anesthesia)and assisted SGB group(n=60,implementing ultrasound-guided SGB combined with general anesthesia).The intraoperative hemodynamics,postoperative stress status[serum cortisol(Cor)and interleukin-6(IL-6)],postoperative pain level[evaluated by visual analogue scale(VAS)score],postoperative biomarkers[serum matrix metalloproteinase-9(MMP-9)and neurospecific protein S-100β(S-100β)],and postoperative cognitive function[evaluated using the mini-mental state examination(MMSE)]were compared between the two groups.Results There was no statistically significant difference in intraoperative blood loss and surgical time between the two groups of patients(P>0.05).After induction of anesthesia(T1),the mean arterial pressure(MAP)and heart rate(HR)of the two groups of patients were significantly lower than when they entered the operating room(T0),the differences were statistically significant(P<0.05).The MAP and HR during the beginning of the surgery(T2),30 min after the start of the surgery(T3),and at the end of the surgery(T4)were higher than those at T0,the differences were statistically significant(P<0.05).While the MAP and HR in the assisted SGB group during T1,T2,T3 and T4 time points were lower than those in the general anesthesia group,the differences were statistically significant(P<0.05).The VAS scores of the assisted SGB group were significantly lower than those of the general anesthesia group at 12 and 24 h after surgery,and the differences were statistically significant(P<0.05).The levels of serum Cor and IL-6 in the two groups at 12 and 24 h after surgery were higher than those at 1 d before surgery,but the levels of serum Cor and IL-6 in the assisted SGB group were lower than those in the general anesthesia group,the differences were statistically significant(P<0.05).The levels of serum MMP-9 and S-100β in the two groups at 24 and 72 h after surgery were higher than those at 1 d before surgery(P<0.05),but the levels of serum MMP-9 and S-100β in the assisted SGB group were lower than those in the general anesthesia group,the differences were statistically significant(P<0.05).The MMSE score of the two groups at 3 and 5 d after surgery were lower than those at 1 d before surgery,but the MMSE score of the assisted SGB group was higher than that of the general anesthesia group,the difference was statistically significant(P<0.05).Conclusion The implementation of ultrasound-guided SGB during shoulder arthroscopic surgery can maintain intraoperative hemodynamic stability,obviously alleviate postoperative stress and pain,obviously reduce serum MMP-9 and serum S-100β levels,and help alleviate postoperative cognitive dysfunction.It is worthy clinical application.

AIM:To explore the correlation be-tween trimethylamine N-oxide(TMAO)and Hashi-moto's thyroiditis(HT)and to provide new ideas for early clinical diagnosis of HT.METHODS:A total of 102 patients with Hashimoto's thyroiditis(HT group)and 204 healthy individuals(control group)were included in the study and clinical data were collected.Serum TMAO levels was determined by stable isotope dilution high-performance liquid chromatography tandem mass spectrometry(HPLC-MS/MS).SPSS 26.0 was used for statistical analysis.RESULTS:Analysis of the baseline data revealed that there was a statistically significant difference between the TMAO levels and gender between the HT group and the control group(P<0.05).In the high-level TMAO group,the proportion of HT(63.7%)was significantly higher than that of the control group(18.6%),the regression analysis showed that high levels of TMAO were correlated with HT and positively correlated with the levels of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TgAb),Logistic regression analysis further revealed that serum TMAO was a risk factor for the development of HT.CONCLUSION:In the TMAO>6.80 μmol/L group,the level of TMAO was correlat-ed with HT,and the high level of TMAO was posi-tively correlated with TPOAb and TgAb,which were risk factors for the occurrence of HT.It is suggested that TMAO can predict the risk of HT and has cer-tain clinical value.

Objective To investigate the impacts of ultrasound-guided stellate ganglion block(SGB)on hemodynamics and postoperative cognitive function in patients undergoing shoulder arthroscopic surgery.Methods From January 2024 to June 2024,120 patients undergoing shoulder arthroscopic surgery in our hospital were randomly assigned into general anesthesia group(n=60,implementing general anesthesia)and assisted SGB group(n=60,implementing ultrasound-guided SGB combined with general anesthesia).The intraoperative hemodynamics,postoperative stress status[serum cortisol(Cor)and interleukin-6(IL-6)],postoperative pain level[evaluated by visual analogue scale(VAS)score],postoperative biomarkers[serum matrix metalloproteinase-9(MMP-9)and neurospecific protein S-100β(S-100β)],and postoperative cognitive function[evaluated using the mini-mental state examination(MMSE)]were compared between the two groups.Results There was no statistically significant difference in intraoperative blood loss and surgical time between the two groups of patients(P>0.05).After induction of anesthesia(T1),the mean arterial pressure(MAP)and heart rate(HR)of the two groups of patients were significantly lower than when they entered the operating room(T0),the differences were statistically significant(P<0.05).The MAP and HR during the beginning of the surgery(T2),30 min after the start of the surgery(T3),and at the end of the surgery(T4)were higher than those at T0,the differences were statistically significant(P<0.05).While the MAP and HR in the assisted SGB group during T1,T2,T3 and T4 time points were lower than those in the general anesthesia group,the differences were statistically significant(P<0.05).The VAS scores of the assisted SGB group were significantly lower than those of the general anesthesia group at 12 and 24 h after surgery,and the differences were statistically significant(P<0.05).The levels of serum Cor and IL-6 in the two groups at 12 and 24 h after surgery were higher than those at 1 d before surgery,but the levels of serum Cor and IL-6 in the assisted SGB group were lower than those in the general anesthesia group,the differences were statistically significant(P<0.05).The levels of serum MMP-9 and S-100β in the two groups at 24 and 72 h after surgery were higher than those at 1 d before surgery(P<0.05),but the levels of serum MMP-9 and S-100β in the assisted SGB group were lower than those in the general anesthesia group,the differences were statistically significant(P<0.05).The MMSE score of the two groups at 3 and 5 d after surgery were lower than those at 1 d before surgery,but the MMSE score of the assisted SGB group was higher than that of the general anesthesia group,the difference was statistically significant(P<0.05).Conclusion The implementation of ultrasound-guided SGB during shoulder arthroscopic surgery can maintain intraoperative hemodynamic stability,obviously alleviate postoperative stress and pain,obviously reduce serum MMP-9 and serum S-100β levels,and help alleviate postoperative cognitive dysfunction.It is worthy clinical application.

AIM:To explore the correlation be-tween trimethylamine N-oxide(TMAO)and Hashi-moto's thyroiditis(HT)and to provide new ideas for early clinical diagnosis of HT.METHODS:A total of 102 patients with Hashimoto's thyroiditis(HT group)and 204 healthy individuals(control group)were included in the study and clinical data were collected.Serum TMAO levels was determined by stable isotope dilution high-performance liquid chromatography tandem mass spectrometry(HPLC-MS/MS).SPSS 26.0 was used for statistical analysis.RESULTS:Analysis of the baseline data revealed that there was a statistically significant difference between the TMAO levels and gender between the HT group and the control group(P<0.05).In the high-level TMAO group,the proportion of HT(63.7%)was significantly higher than that of the control group(18.6%),the regression analysis showed that high levels of TMAO were correlated with HT and positively correlated with the levels of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TgAb),Logistic regression analysis further revealed that serum TMAO was a risk factor for the development of HT.CONCLUSION:In the TMAO>6.80 μmol/L group,the level of TMAO was correlat-ed with HT,and the high level of TMAO was posi-tively correlated with TPOAb and TgAb,which were risk factors for the occurrence of HT.It is suggested that TMAO can predict the risk of HT and has cer-tain clinical value.

ObjectiveTo investigate the material basis and mechanism of Arnebia euchroma against hepatocarcinoma by network pharmacology， and to verify the potential targets of A. euchroma against hepatocarcinoma by molecular docking and experiments. MethodThe main active ingredients of A. euchroma were collected by retrieving the literature through China National Knowledge Network （CNKI） and Traditional Chinese Medicine System Pharmacology Database and Analysis Platform（TCMSP）. The active ingredients were screened out by FAFDrug4 platform according to the pharmacokinetics （ADME） properties of the drugs. The screening compounds and liver cancer targets were collected by using several databases and analyzed by drawing Venn diagrams. The protein-protein interaction （PPI） network was constructed by Cytoscape and STRING database. DAVID database was used to perform Gene Ontology （GO） functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis of key targets. Autodock was used to perform molecular docking of targets on core pathways. Cell counting kit-8 （CCK-8） experiment was carried out to validate the activities of five naphthoquinones. Based on the predicted results in the H22 tumor-bearing mouse model， the key targets of isovalerylshikonin against hepatocarcinoma were verified by hematoxylin-eosin （HE） staining， enzyme-linked immunosorbent assay （ELISA）， and Western blot assay. ResultFifty-five active ingredients and 34 targets of active ingredients against hepatocarcinoma were screened out. The active molecules with high degree values in the “drug-active ingredient-target-disease” network were mainly naphthoquinones. PPI network obtained several core targets of A. euchroma against hepatocarcinoma. Twenty-two pathways were screened out by KEGG analysis， mainly involving phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， vascular endothelial growth factor （VEGF）， tumor necrosis factor （TNF）， and other signaling pathways. The results of molecular docking showed that the five naphthoquinones had a good affinity with the targets of the PI3K/Akt signaling pathway. The results of CCK-8 and animal experiments showed that the lipid-soluble component isovalerylshikonin had good anti-cancer potential， and the high-dose group reduced the serum levels of VEGF and alpha fetoprotein （AFP） levels and elevated interferon-γ （IFN-γ） level （P<0.05， P<0.01）. The high-dose group also down-regulated phosphorylate（p）-Akt （Ser473） and B-cell lymphoma （Bcl）-2 protein expressions and up-regulated Bcl-2-antagonist of cell death （Bad） protein expression （P<0.01）. ConclusionA. euchroma can inhibit hepatocarcinoma cell proliferation and tumor angiogenesis and induce cancer cell apoptosis through the PI3K/Akt signaling pathway， which provides ideas and clues for the subsequent in-depth investigation of its specific mechanism.

OBJECTIVE: To study the expression and significance of hMSH2 protein in laryngeal squamous cell carcinoma. METHOD: The expression of hMSH2 protein were detected by immunohistochemistry SP method in 51 cases of laryngeal squamous cell carcinoma, the control group included 30 cases of atypical hyperplasia tissue of vocal fold and 16 cases of normal laryngeal tissue. RESULT: The expression rates of hMSH2 in laryngeal squamous cell carcinoma, atypical hyperplasia tissue of vocal fold and normal laryngeal tissue were 58.8%, 73.3%, 87.5% respectively. There was significant difference among them (P < 0. 05). The expression of hMSH2 in laryngeal carcinoma was not associated with location and T stage (P > 0.05), but the expression was related with metastasis of lymph node and differentiation level (P < 0.05). CONCLUSION The deletion of hMSH2 maybe participate the early occurrence of laryngeal carcinoma; hMSH2 protein maybe delay and suppress oncogenesis and development of laryngeal carcinoma.
Carcinoma, Squamous Cell ; metabolism ; pathology ; Case-Control Studies ; Head and Neck Neoplasms ; metabolism ; pathology ; Humans ; Hyperplasia ; Immunohistochemistry ; Laryngeal Neoplasms ; metabolism ; pathology ; MutS Homolog 2 Protein ; metabolism ; Squamous Cell Carcinoma of Head and Neck